2022 ACA Affordability Percentage
The 2022 ACA Affordability Percentage is 9.61%.
Effective 2022-01-01Source: Rev. Proc. 2021-36 (IRS)Verified 2026-08-30
Required contribution percentageSource: Publication 974 (2022), Premium Tax Credit (PTC) (IRS)Verified 2026-08-30
Compared with 2021
| Item | 2021 | 2022 | Change |
|---|---|---|---|
| Required contribution percentage | 9.83% | 9.61% | -0.22% (-2.2%) |
Who it applies to
Individuals determining whether employer-sponsored minimum essential coverage is affordable under the Affordable Care Act for plan years beginning in calendar year 2022.
What changed this year, and why
For plan years beginning in calendar year 2022, the ACA Required Contribution Percentage is 9.61%, as set by IRS Revenue Procedure 2021-36. This percentage determines whether employer-sponsored health coverage is affordable for purposes of the premium tax credit under IRC § 36B.
Common questions
- What is the Required Contribution Percentage used for?
- It is used under IRC § 36B to determine whether employer-sponsored minimum essential coverage is considered affordable. If an employee's required contribution for self-only coverage exceeds 9.61% of household income, the coverage is not affordable and the employee may qualify for a premium tax credit.
- How is this percentage adjusted each year?
- It is published annually by the IRS based on premium growth relative to income growth, as determined by the Department of Health and Human Services.
Every amount on this page is a published figure rather than yours. The Affordable employer coverage calculator takes the number you enter and works it out against them, showing which published figure it used.
The share of household income that makes an offer affordable
An employer plan is generally considered affordable if the employee's share of the annual cost for self-only coverage - called the "employee required contribution" - is no more than 9.61% of the tax family's household income for 2022. The calculation uses self-only coverage even when the employee would actually enroll in family coverage because of a spouse or dependents. If the required contribution exceeds that 9.61% threshold, the offer of coverage is not affordable and the employee (and possibly family members) may be eligible for the premium tax credit on a qualified health plan purchased through the Marketplace. However, if the employee gave accurate information about employer coverage to the Marketplace and the Marketplace still allowed advance premium tax credit (APTC) on a qualified health plan, the employer coverage is treated as not affordable regardless of the dollar math. That safe-harbor rule prevents an employer from later claiming the coverage was affordable when the Marketplace has already determined otherwise based on the information provided at enrollment.
Your em- ployer coverage is generally considered affordable for you and for a family member if your share of the annual cost for self-only coverage, which is sometimes referred to as the “employee required contribution,” is not more than 9.61% of your tax family’s household income for 2022.
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
An affordable offer blocks the premium tax credit
An employer-sponsored health plan must satisfy two separate tests before it can block a person from claiming the premium tax credit on Marketplace coverage: it must be affordable and it must provide minimum value. If the employer plan fails either test, the individual is not considered eligible for the employer plan for premium-tax-credit purposes and may be able to receive a credit for a qualified health plan. However, if an employee (or a family member) actually enrolls in the employer plan, that person cannot get the premium tax credit for the plan year - even if the coverage is not affordable or does not provide minimum value. The two conditions work together to determine whether the offer of coverage counts as accessible, eligible employer-sponsored coverage that prevents someone from claiming a tax credit.
Even if you had the opportunity to enroll in coverage offered by your em- ployer that qualifies as MEC, you are considered eligible for an employer-sponsored plan (and cannot get the PTC for your coverage in a qualified health plan) only if the em- ployer-sponsored coverage is affordable (defined later) and the coverage provides minimum value (defined later).
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
The second test an employer plan has to fail
An employer-sponsored health plan must provide minimum value to block a person from claiming the premium tax credit on Marketplace coverage. A plan provides minimum value only if it pays at least 60% of the total allowed costs of benefits for a standard population and provides substantial coverage of inpatient hospitalization services and physician services. If a plan fails this test - meaning it covers less than 60% of allowed costs - the individual is not considered eligible for employer coverage and may qualify for a premium tax credit on a qualified health plan purchased through the Marketplace, even if the plan would otherwise be considered affordable under the 9.61% threshold test.
How to determine if a plan provides minimum value. An employer-sponsored plan provides minimum value only if the plan pays at least 60% of the total allowed costs of benefits for a standard population and provides sub- stantial coverage of inpatient hospitalization services and physician services.
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
A waiting period is not coverage you can use
An individual is not considered eligible for employer-sponsored health coverage during a month when benefits cannot be received under the plan - for example, during a waiting period before the employer coverage becomes effective. During such a month, the individual can get the premium tax credit for coverage in a qualified health plan if otherwise eligible. However, if the individual could have enrolled in employer coverage that is minimum essential coverage, affordable, and provides minimum value but did not enroll during an enrollment period, the individual cannot get the premium tax credit for the remainder of the plan year to which the enrollment period related.
You are not considered eligible for employer coverage, and can get the PTC for your coverage in a qualified health plan if you are otherwise eligible, for a month when you cannot receive benefits under the em- ployer coverage (for example, you are in a waiting period before the employer coverage becomes effective).
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
Which plans are eligible employer-sponsored coverage
Eligible employer-sponsored plans include group health insurance plans offered in the group market, self-insured group health plans for employees, coverage under certain expatriate health plans for employees, and the Nonappropriated Fund Health Benefits Program of the Department of Defense. These plans may also include retiree or COBRA coverage. Plans that are minimum essential coverage are also referred to as "eligible employer-sponsored plans." Exceptions exist for coverage that is limited to excepted benefits, such as stand-alone vision or dental plans, workers' compensation coverage, or coverage limited to a specified disease or illness - such coverage is not minimum essential coverage and therefore does not count as eligible employer-sponsored coverage for premium tax credit purposes.
Employer-sponsored plans that are MEC are also refer- red to as “eligible employer-sponsored plans.”
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
How each figure was verified
Each number below was read from a stored copy of the document named beside it, and checked to occur word for word in the quoted sentence. The digest is of that stored text.
Publication 974 (2022), Premium Tax Credit (PTC) (IRS)
- Required contribution percentage
Your employer coverage is not considered affordable if, when you enroll in a qualified health plan, the Marketplace determines that your required contribution for employer coverage will be more than 9.61% of what the Market- place estimates will be your household income and there- fore that you are eligible for APTC for coverage in the qualified health plan.